Colonoscopy with Glue injection

A colonoscopy involves inserting a flexible tube with a camera (colonoscope) into the colon to examine its inner lining. During this procedure, doctors can detect polyps, ulcers, tumors, varices, and bleeding sites.

When a bleeding site or fragile vascular lesion is found, doctors may perform a glue injection. The glue (commonly N-butyl-2-cyanoacrylate) acts as a tissue adhesive that quickly hardens upon contact with blood, sealing the bleeding point or varix.

When is Glue Injection During Colonoscopy Needed?

Colonoscopy with glue injection is recommended in certain conditions, such as:

• Colonic varices – Abnormally swollen veins in the colon that can rupture and bleed.
• Severe gastrointestinal bleeding – When traditional methods like cauterization or clipping are not effective.
• Ulcer-related bleeding – Controlling persistent bleeding in colonic ulcers.
• Anastomotic leaks – Sealing leaks after colorectal surgery.
• Rare vascular malformations – Such as angiodysplasia causing recurrent bleeding.

Preparation for Colonoscopy with Glue Injection

Preparation is similar to a standard colonoscopy and includes:

• Dietary changes – Low-fiber diet followed by clear liquids 24 hours before the procedure.
• Bowel cleansing – Drinking a laxative solution to completely empty the colon.
• Medication adjustments – Informing the doctor about blood thinners or anticoagulants, as these increase bleeding risk.
• Fasting – No food or drink for 6–8 hours before the procedure.

How is Colonoscopy with Glue Injection Performed?

The procedure usually takes 30–60 minutes and involves the following steps:

• Sedation – Patients are given sedatives or anesthesia for comfort.
• Colonoscope insertion – The scope is advanced through the rectum into the colon.
• Identification of bleeding site or varix – The doctor examines the colon lining for bleeding or abnormal veins.
• Glue injection – Using a fine injection needle passed through the scope, medical glue is directly injected into the lesion or varix.
• Sealing effect – The glue polymerizes rapidly, sealing the lesion and stopping the bleeding.
• Completion – The colon is re-inspected to ensure bleeding has stopped before removing the scope.

Benefits of Colonoscopy with Glue Injection

• Immediate bleeding control – Quick and effective for severe bleeding.
• Minimally invasive – Avoids the need for emergency surgery in many cases.
• Effective for high-risk patients – Useful when surgery carries higher risks.
• Seals leaks and varices – Provides both diagnostic and therapeutic advantages.
• Life-saving – Especially for patients with massive lower GI bleeding.

Risks and Complications

Though generally safe, some risks may occur:

• Glue migration – Rarely, glue may travel to other organs.
• Colon perforation – A very rare but serious risk.
• Allergic reaction – Extremely uncommon, but possible.
• Re-bleeding – May occur if the varix or lesion reopens.
• Infection – Though rare, infection risk exists after tissue injection.

Recovery and Aftercare

After the procedure:

• Observation – Patients are monitored for several hours until sedation wears off.
• Mild symptoms – Some bloating, cramping, or minor bleeding may occur.
• Diet – Most patients can resume a normal diet the same day, unless advised otherwise.
• Activity – Avoid heavy exercise or strain for 24–48 hours.
• Follow-up – Regular checkups and repeat colonoscopies may be recommended to monitor healing and prevent recurrence.

Colonoscopy with Glue Injection vs. Other Treatments

• Endoscopic clipping/cauterization – Works for small bleeding points, but glue is better for large varices or stubborn bleeding.
• Surgery – More invasive, with longer recovery. Glue injection offers a safer, quicker alternative.
• Band ligation – Common for esophageal varices but less effective for colonic varices.

Success Rates of Colonoscopy with Glue Injection

Studies show that colonoscopy with glue injection has a success rate of over 85–95% in controlling acute bleeding from colonic varices and vascular lesions. In many cases, it prevents the need for emergency surgery and improves survival in high-risk patients.

When Should You Consider This Procedure?

• Unexplained rectal bleeding
• Severe anemia due to GI blood loss
• Known colonic varices or vascular malformations
• Bleeding after bowel surgery